title: Drug-induced long QT syndrome in women.
abstract: Congenital long QT syndromes (LQTS) are inherited heart diseases that can present as palpitations, syncope (fainting), seizures, cardiac arrest, and sudden death. Acquired LQTS mostly occurs as a result of exposure to an environmental stressor that is responsible for the excessive prolongation of the QT interval. The most common environmental stressor is adverse drug reactions, which can lead to drug-induced LQTS (di-LQTS). Female gender has been increasingly recognized as an independent risk factor for di-LQTS, which in females is influenced by other factors, including age, menstrual cycle, and hormone replacement therapy. The estrogen-mediated reduced repolarization reserve in women is believed to be responsible for their higher susceptibility to di-LQTS. More studies, especially randomized trials, should be carried out to confirm these findings, and elucidate the clinical impact of gender disparity in modifying the risk of di-LQTS in women, with the ultimate goal of promoting the clinical safety of medication. In this article, we review current knowledge about di-LQTS, specifically in women, and discuss methods for the prevention of di-LQTS in females.
authors.affiliation: Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University College of Medicine, No. 277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China.
authors.forename: Guoliang
authors.initials: G
authors.lastname: Li
authors.forename: Gong
authors.initials: G
authors.lastname: Cheng
authors.forename: Jine
authors.initials: J
authors.lastname: Wu
authors.forename: Xin
authors.initials: X
authors.lastname: Zhou
authors.forename: Ping
authors.initials: P
authors.lastname: Liu
authors.forename: Chaofeng
authors.initials: C
authors.lastname: Sun
mesh_terms: D000200:Action Potentials / Q000502:physiology; D000367:Age Factors; D000701:Analgesics, Opioid / Q000009:adverse effects; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects; D000890:Anti-Infective Agents / Q000009:adverse effects; D000932:Antiemetics / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects; D014150:Antipsychotic Agents / Q000009:adverse effects; D002121:Calcium Channel Blockers / Q000009:adverse effects; D004562:Electrocardiography; D004958:Estradiol / Q000502:physiology; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D004967:Estrogens / Q000502:physiology; D005260:Female; D005765:Gastrointestinal Agents / Q000009:adverse effects; D006633:Histamine Antagonists / Q000009:adverse effects; D006801:Humans; D008133:Long QT Syndrome / Q000139:chemically induced*; D008597:Menstrual Cycle / Q000502:physiology; D011374:Progesterone / Q000502:physiology*; D012737:Sex Factors; D016171:Torsades de Pointes / Q000139:chemically induced*
chemical_list: D000701:Analgesics, Opioid; D000889:Anti-Arrhythmia Agents; D000890:Anti-Infective Agents; D000932:Antiemetics; D000970:Antineoplastic Agents; D014150:Antipsychotic Agents; D002121:Calcium Channel Blockers; D004967:Estrogens; D005765:Gastrointestinal Agents; D006633:Histamine Antagonists; D011374:Progesterone; D004958:Estradiol